The Importance of Strength Training for Older Women
Strength training is not just for men, on the contrary it is one of the most important things you should be doing as an older woman.
Strength training is not just for men.
Strength and balance training is hugely important for women, particularly as you age, from both a physical and mental health perspective.
However, a lot of older women find gyms intimidating and find the thought of lifting weights scary or are held back by the idea of weight and strength training being “not for women”.
On the contrary it absolutely is, for the following reasons, and a whole lot more!
Improves your bone density and reduces risk of osteoporosis
Improves mobility and reduces your falls risk as you age
Improves some menopausal and pelvic floor symptoms
Improves your sleep quality and mood
Improves your cardiovascular health
Can help with weight fluctuations due to hormone changes
Empowers you to do more independently and feel safer within yourself
As you start to reach menopause your levels of oestrogen and other hormones drop. Because oestrogen helps maintain bone density, this drop can lead to significant bone loss and to low bone density over time.
Weight bearing and resistance (strength) training signals to the body to keep regenerating bone which helps to maintain your bone density. It also builds muscle, tendon and ligament strength to support your joints, and lift heavy things on your own!
Improved strength, balance and agility means you are less likely to fall, and also less likely to injure yourself badly if you were to fall. You will also be able to get yourself up off the ground after a fall, which is extremely important particularly if you live alone.
Menopause can also cause an increase in pelvic floor and incontinence symptoms as you begin to lose elasticity of the muscles of the pelvic floor.
Combining pelvic floor exercises with your strength training, and adding in things like small jumps and change of direction movements teaches your pelvic floor how to contract and relax quickly. This can be helpful for situations in life like jumping off a small wall, sneezing or running small distances.
Why you might avoid strength training, even when you know the benefits.
Often it can feel intimidating going into the gym or the weights section. It may feel like lifting weights is just for men or people in their 20s!
While there are many gyms, bootcamps and group exercise classes that are designed for women, we know that sometimes even the thought of starting those without any previous experience, or “knowing what you are doing” can be rather terrifying.
You’re possibly worried about injuring yourself or don’t believe that you can lift the heavy weights.
You’re worried about getting “bulky” or “too muscular”.
You might avoid doing classes because they involve jumping or running, which very often causes stress urinary incontinence (leaking urine).
You might have even been told in the past that lifting weights would damage the pelvic floor. However we now know that with the correct technique and slow progression of weights, you can actually improve your symptoms by strengthening the pelvic floor along with the rest of the body.
How we can help you move beyond these (sometimes literal!) hurdles:
We start off with one-on-one sessions so you will be completely supported and not have to worry about “knowing what to do”.
As Physiotherapists we are experienced with training around pain and injuries and can modify almost anything to allow you to still exercise safely.
As we have extra experience in strength training we are able to help you progress from injury or a low baseline in strength, right up to competence in doing things you probably never realised you were capable of!
You will not get bulky or big with the kind of exercise we’ll be doing, the kind of training needed to build visibly big muscles requires a specific kind of training and diet, repeated for years! You will likely just improve your muscle tone.
We are all trained in pelvic floor rehabilitation and so can incorporate exercises that will improve your function, as well as give you appropriate exercises that won’t stress the pelvic floor beyond your current capabilities.
Does this sound like something you would like help with? Feel free to book an Initial Assessment via our booking page with any of our experienced team.
Click the button below.
Alternatively give us a call on 0422 483 865 or email admin@formotionphysio.com.au
We have locations within gym settings in Osborne Park, West Perth and Joondalup
How to talk to your clients about women's health issues
Personal trainers and coaches are in a unique position where they can screen the general population and the athletes they work with for issues that they may otherwise not feel comfortable bringing up, or not even know that there are solutions to in the first place.
For personal trainers, coaches and fitness professional.
Women’s health issues are very common, but sadly there is not much awareness around it which leaves huge gaps in potential not only for health and quality of life, but also performance.
Women’s Health Physiotherapists and other health professionals who specialise in this area will often only see people when the symptoms have become very extreme.
Personal trainers and coaches are in a unique position where they can screen the general population and the athletes they work with for women’s health issues that they may otherwise not feel comfortable bringing up, or not know that there are solutions to in the first place!
We know that it can be pretty daunting and uncomfortable talking about these issues, especially for men.
Some advice we can give on this is to try and include regular general discussions about it in all of your sessions. Many women may feel embarrassed to raise these issues themselves which is why it’s important to not make it taboo by discussing it regularly, so they know that whatever they are experiencing is nothing to be embarrassed about.
Upskilling in this area will also help you to feel more confident talking about it, see the end of this blog for some links to great resources.
If you don't feel comfortable talking about it, putting a few of the questions below into your initial screening can alert you to refer on if necessary.
Women’s Health Questions to ask:
1. Do you ever experience leakage, or feel like you may leak, during things like heavy lifting, skipping, sneezing or coughing?
Answering yes to this could indicate Stress Urinary Incontinence.
2. Do you ever experience the feeling of pressure in your pelvis/pelvic floor during during things like heavy lifting, skipping, sneezing or coughing
Answering yes to this could indicate symptoms of prolapse.
3. Has your menstrual cycle been normal the past couple of months? (Assuming client is not pregnant or on hormonal contraceptive).
Changes to menstrual cycles can alert you to signs of RED-S in athletes or people that train intensely.
4. How does your cycle affect your mood/energy levels?
Understanding your client’s individual responses to their cycle can help you to plan sessions around this to help them perform at their best.
What to do if your client is having issues?
Considering the pelvic floor and menstrual cycle during training is important, but if your client is having issues they will often need a health professional to diagnoses and treat, at least initially.
Normally these health professionals will aim to work with you and your client to get them back to training with confidence.
At Formotion Physio we have an interest in Women’s Health, and are able to assist with returning to exercise with consideration of the pelvic floor, but we would recommend referring to a Women’s Health Physiotherapist for pelvic floor issues first.
For menstrual cycle or hormonal issues we would recommend referring to a Women’s Health GP or Sports Medicine Physician, particularly if you suspect RED-S (see below) or other more serious health issues.
You can find directory of Women’s Health Physiotherapists on the Australian Physiotherapy Association - Find Physio page here.
A few resources on the topic that we think are helpful and important are listed below:
Continence Foundation of Australia
Julie Wiebe - Women’s Health Physical Therapist
“Pop Up Lift” Instagram page & Website
Jessie Mundell - Pregnancy and Post Natal Fitness Coach
RED-S Relative Energy Deficiency in Sport
RED-S Clinical Assessment Tool
If you know of anymore to add to this list please get in touch or comment on this blog.
Incontinence During Exercise
Leaking during exercise. What causes it, and what you can do about it.
Does the idea of double unders, box jumps or running make you need to rush off to toilet before you start your workout?
If you've ever leaked, or felt like you might during these movements or things like sneezing or laughing, you might have something called Stress Urinary Incontinence (SUI).
SUI is a pelvic floor issue that affects many women (and men!) whether you've had kids or not, and is common in sports that have movements involving jumping/high impact or heavy weights.
While it is common, it does not mean it is normal.
There are exercises and strategies you can learn that can teach your pelvic floor how to function during these more demanding activities.
What is the Pelvic Floor?
The culprit is likely to be the trampoline-like group of muscles at the bottom of your pelvis called the Pelvic Floor.
The pelvic floor is important when it comes to controlling when, and when you don't go to the toilet. It is also important for supporting and keeping all your abdominal and pelvic organs inside you, as well as during sexual function.
If this group of muscles isn't working correctly and the pressure in your abdominal area increases suddenly - for example if you lift heavy/jump/cough/sneeze or bend over quickly, the control and contraction it normally puts around the urethral and anal sphincters to stop you going, can be overcome by the pressure, which can lead to leaking either urine or faeces.
What can you do about it?
Traditional pelvic floor exercises, sometimes known as "kegels", are the ones that are recommended most often. These are the ones where you squeeze as if you're trying not to go to the toilet, and are usually encouraged while you’re relaxing in sitting or standing, like at traffic lights or queue at the checkout.
While these can be a good first step to creating awareness of these muscles, they don’t give you the full picture. This may be why you can you still have problems when it comes to intense exercise and coughing/sneezing, even if you are religiously doing them.
Pelvic floor “weights” have also become quite popular recently, however these also have their limitations (see below).
Make sure you are able to contract, and relax correctly.
It may be that you are weak, the muscles are too tight, or you are not using the muscles correctly.
It is important that you are able to gently “lift” the muscles. The action is the one you would use to stop yourself going to the toilet, you should have awareness and be able to control both the front and back passage. Often people will have more control of one but not the other so it may give the perception of good function, but in reality there is a lack of control where it matters.
The ability to relax when required is also just as important as this allows you to go to the toilet, for sexual function and also to rest the muscles.
A muscle that is always wound up and switched on will eventually become too fatigued to react and work when it is required. They can also cause pain with penetration in some cases.
*This is why pelvic floor “weights”, which you generally walk around with for a long time without getting that all important rest and relax time, are not recommended.
Try it.
1) Lie down or sit in a deep squat if you can.
2) Imagine you are trying to hold in a wee. A cue we love is “Pick up a jelly bean with your vagina”. For men a good cue is “Nuts to guts”. It should just be a small contraction, imagine it is moving about 5mm.
3) Relax and notice if it feels like the pelvic floor is dropping back down.
4) Now try it with your back passage, as if you are trying to hold in wind. Usually this one is easier so make sure you can differentiate between the front and back.
5) Then try and do them both at the same time. Making sure to relax in between.
6) You can build strength by performing a strong or hard contraction, for example a “1cm” lift which you can try to hold for 2-5sec.
7) For endurance try to hold a gentler contraction for a longer; 10-20 seconds for example.
A cue we don’t love is “belly button to spine” because this generally cues the upper abs and can create more downward pressure on the pelvic floor.
Test it.
A quick test you can try is attempting to stop a stream of wee while on the toilet, if you can then you’re likely to be contracting the muscles correctly.
If you can’t, or you end up “pushing down” then this is probably a sign that you lack strength and awareness and you’ll probably need some help from a Women's/Men’s Health Physiotherapist to teach you how to to activate correctly.
Make sure you only do this very occasionally as doing it too often increases your risk of urinary tract infections.
Combine it with functional exercise.
Once you are confident with this then the next step is to make sure your strength and timing is working well during more complex and intense activities.
As we explained before, instead of being constantly contracted, your pelvic floor should be able to respond fairly automatically to these sudden increase in pressure at the right time, and relax when the pressure subsides so that the muscles can rest.
Randomly squeezing and relaxing your pelvic floor, without training towards a functional goal can be likened to just tensing and relaxing your biceps, instead of using them to bend your elbow at the time you need to lift something up.
Functional Example
Gently squeezing and lifting right before you go for a 1RM squat.
Cueing a few “quick squeezes” before you start a round of skipping to get the muscles and nervous system ready for the type of contraction it will need to be doing.
Your body is also designed to work in movement patterns, as opposed to using single specific muscles. When there is a functional goal this cues a movement pattern that can create more force than an isolated contraction. For example your bicep will create more force by climbing up a rope than by simply tensing it as hard as you can. In the same way, your pelvic floor is better engaged during an action that has the context of a useful function.
Consider the big picture of technique.
To give your pelvic floor the best chance of being able to manage extra pressure, make sure the rest of your technique is spot on to put your body in the best position for the pelvic floor to work at its best.
For example if you are “donkey kicking” during your double unders (skipping) the force you are hitting the ground with a lot more, this means that the downward force of your abdominal contents onto your pelvic floor is also a lot more which can overcome even a relatively strong and coordinated pelvic floor.
Your running and lifting technique will also play a big part in this.
Train your pelvic floor like you would any other muscle.
Once your technique has been considered, train in a way that works within your body’s limits.
For example if you are leaking after 20 skips then this is more than your max. Instead try building up your endurance by starting with 3x10 skips and build up from there.
If you feel like you are about to leak with an 80kg squat, then maybe 79kg is your 1RM? Adjust your mindset so that even if you can lift the weight it doesn’t count unless your pelvic floor is able to lift it to.
This is how you’ll keep yourself safe and be able to continue the sport you love in the long run.
Where to from here?
We can only fit so much information in a blog, and this information might not be appropriate for your individual needs.
So as usual we’d suggest getting help from a professional to first help you figure out the reasons it might not be functioning correctly and address these issues first.
Once you’ve done that you can begin learn how to improve your awareness of it and incorporate it into your daily life or training. This is something we can help you with as it is often a lot more complex than what we’ve written here.
If you have any issues related to traumatic childbirth or have severe issues we’d suggest seeing a specialist Women’s Health Physiotherapist. Feel free to contact us for any recommendations.
By Lucia Tennant
Principal Physiotherapist
B.Sc. Physiotherapy
Director - Formotion Physio
lucia@formotionphysio.com
Formotion Physio is a Physiotherapy practice based in West Perth & Osborne Park, Western Australia